Fevers: Facts, Stats and Trends in India
A fever is a condition in which the average or normal body temperature rises above 98.6°F or 37°C. It can either be caused by pathogens or act as a secondary symptom to other illnesses.
Checking for fever, Image Credit: pexels
Here are some Tropical fevers facts, statistical records, and trends in India:
1) Areas and countries in the tropical and subtropical regions on the globe are prone to febrile infections caused by pathogens like a number of viruses, bacteria, and protozoa. This condition or illness that is unique to these specific regions is known as Tropical fever.
2) The most common and prevalent tropical fevers in India are:
Scrub typhus: It contributes to 18.2% of total cases in India with more than 1 million cases occurring annually. This acute febrile illness is dominant during the monsoons and winters.
Malaria: WHO estimates 15 million cases and 20,000 deaths due to malaria in India, annually. It contributes to 8.1% of total cases. estimate for 96 million cases and 40,000 deaths every year. It contributes to 23%
Dengue: Around 3.9 million Indians are at risk of contracting dengue, with an of cases of tropical fevers in India.
Typhoid or enteric fever: It contributes to 1.1% of total cases. India, along with Bangladesh and Pakistan, is one of the top countries with the highest rates of travel-associated typhoid. In 2015, 18,45,997 cases were reported with 393 deaths.
Leptospirosis: It contributes to 1.5% of tropical fever cases with less than 10,000 cases are reported, annually. Most cases originate from states like Kerala, Gujarat, Tamilnadu, and Maharashtra. Although, WHO estimates an annual report of 0.1-1.0 cases a year.
Sepsis: In southeast Asia, India has the second-highest sepsis death rate and contributes to 7% of total cases of tropical fevers India. It has a death rate of 213 per 1,00,000 people.
Meningitis: It accounts for 8.1% of total cases. Between 2014 and 2015, around 16, 217 cases and 300 deaths were reported in India with the highest number of cases originating from Bihar (8871 cases).
3) Cause: Although tropical fever occurs throughout the year, the number of cases are skyrocketed during the monsoon and post-monsoon season.
This is because when the temperature initially goes down during the end of summer and the start of monsoon, humidity rises and water collects in areas. This condition makes it extremely favorable for mosquitoes to breed and thrive and spread vector-borne diseases that commonly cause fever.
In addition to that, the rising problem of climate change has lead to unpredicted rainfall, and as a result, rainwaters get accumulated in construction areas and other places. This further aids in the breeding of mosquitoes.
4) There are five variations of fever prevalent in India:
Intermittent Fever: A condition where the body temperature remains 37° C during the day but rises during the night. It is typically caused by parasitic or bacterial infections.
Sudden High Fever: A sudden increase in the body temperature followed by tiredness, fatigue, body ache and headache
Continuous Fever: The body temperature is above nominal levels throughout the day and remains constant.
Remittent Fever: This condition is similar to Continuous fever but the temperature can continuously fluctuate by a small difference.
Rheumatic Fever: This condition is caused by the streptococcal bacteria which initially causes throat infection but which when left untreated, can lead to painful fever.
Moreover, white spots appear on the tonsils and tongue along with inflammation and headache.
Most common fever types and medical diagnosis in India, Image Credit: Pikist
5) The symptoms of most tropical fevers tend to overlap with one another and are difficult to diagnose at the time of presentation. This is why all similar emergency cases in the ICU must be suspected and treated as a serious illness by physicians in order to decrease morbidity and mortality.
In order to diagnose the illness or disease, physicians have divided tropical fevers into five major syndromes:
Undifferentiated fever: Malaria, dengue, scrub typhus, leptospirosis, typhoid, and other common viral fevers.
Fever with a rash: Rickettsial infections, meningococcal infection, malaria, measles, rubella, and dengue.
Fever with acute respiratory distress syndrome (ARDS): Scrub typhus, falciparum malaria, influenza ( H1N1), leptospirosis, hantavirus infection, melioidosis, severe community-acquired pneumonia, and diffuse alveolar hemorrhage.
Fever with encephalopathy: Encephalitis, meningitis, scrub typhus, cerebral malaria, and typhoid encephalopathy.
Fever with multi-organ dysfunction: Dengue, sepsis due to bacteria, falciparum malaria, leptospirosis, hepatitis A or E, Hantavirus, hemophagocytosis, and macrophage activation syndrome.